Organization Active NPI

Lifetime Value Pharmacy III, Inc.

  • Pharmacy
  • Santa Ana, CA
National Provider Identifier
1407296742
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
51442 Issued in CA
Legal business name
LIFETIME VALUE PHARMACY III, INC.
Practice address
406 W 17TH St
Santa Ana, CA 92706-3609
Phone
(714) 862-2470
Fax
(714) 862-2471
NPI assigned
Jul 1, 2013
Last updated
Feb 3, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ryan Linh Le
Title
Vice President
Phone
(714) 862-2470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 51442 CA Primary

Addresses

Primary practice location

406 W 17TH St
Santa Ana, CA 92706-3609

Mailing address

406 W 17TH St
Santa Ana, CA 92706-3609
Phone (714) 862-2470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150202001638 CA DME Supplier - Pharmacy 2961727581 Practice locations: Santa Ana, CA
O20180223002478 CA Part B Supplier - Pharmacy 2961727581 Practice locations: Santa Ana, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Lifetime Value Pharmacy406 W 17TH St, Santa Ana, CA 92706-3609(714) 497-6246 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Does not accept assignmentParticipating since Oct 6, 2014

National Provider Directory

National Provider Directory

Locations

301 E 17th St
Santa Ana, CA 92706
Phone (714) 592-6796

406 W 17th St
Santa Ana, CA 92706
Phone (714) 862-2470

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770076800000",
    "number": "1407296742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063609",
            "telephone_number": "714-862-2470",
            "fax_number": "714-862-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 W 17TH ST",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927063609",
            "telephone_number": "714-862-2470",
            "fax_number": "714-862-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME VALUE PHARMACY III, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-01",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "LINH",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "714-862-2470",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "51442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.